Scatter diagram analysis system and method for discriminating ventricular tachyarrhythmias

• US 5,404,880 A
• Filed: 10/05/1993
• Issued: 04/11/1995
• Est. Priority Date: 10/05/1993
• Status: Expired due to Fees

• Current Assignee: Board of Regents of the University of Nebraska
• Original Assignee: Board of Regents of the University of Nebraska
• Inventors: Throne, Robert D.
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): Getzow, Scott M.
• Application Number:
  US08/131,648
• Time in Patent Office: 553 Days
• Field of Search: 128/696, 128/705, 128/706, 128/702
• US Class Current: 600/518
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion

Abstract

A computationally efficient two channel scatter diagram analysis algorithm for distinguishing monomorphic ventricular tachycardia (VT) from polymorphic ventricular tachycardia and ventricular fibrillation (VF). Scatter diagram analysis plots the amplitude from one channel (morphology) versus the amplitude from another channel (rate) on a graph with a fifteen-by-fifteen grid. A fraction or percentage of the 225 grid blocks occupied by at least one sample point is then determined. Monomorphic VT traces nearly the same path in space and occupies a smaller percentage of the graph than a non-regular rhythm such as polymorphic VT or VF.

Claims

1. A method of discriminating ventricular tachyarrhythmias, comprising the steps of:

(a) receiving data representing a first channel and a second channel both recording electrocardiographic signals from a patient'"'"'s heart;

(b) generating a series of data points, each of the data points having a first data element corresponding to the first channel and a second data element corresponding to the second channel; and

(c) discriminating ventricular tachyarrhythmias of the patient by determining a value representing a distribution of the data points.

2. The method of claim 1 wherein step (c) comprises the steps of:

(a) assigning memory addresses to a predetermined range of the data points; and

(b) determining how many of the memory addresses correspond to at least one of the data points.

3. The method of claim 2 wherein step (c) further comprises the step of determining a percentage of the memory addresses that correspond to at least one of the data points.

4. The method of claim 3 wherein step (c) further comprises the step of determining if the percentage is greater than or less than a predetermined threshold value.

5. The method of claim 1 wherein step (c) comprises the step of discriminating monomorphic ventricular tachycardia from polymorphic ventricular tachycardia of the patient by comparing the value to a predetermined threshold value.

6. The method of claim 1 wherein step (a) comprises the steps of:

(a) receiving a first electrocardiographic signal from the patient'"'"'s heart and a corresponding second electrocardiographic signal from the patient'"'"'s heart; and

(b) sampling the first electrocardiographic signal and the second electrocardiographic signal in order to obtain the data.

7. The method of claim 1 wherein step (a) comprises the step of applying a moving average filter to the data.

8. The method of claim 1 wherein step (a) comprises the step of receiving data representing morphology and corresponding rate measurements of the patient'"'"'s heart.

9. A method of discriminating ventricular tachyarrhythmias, comprising the steps of:

(a) receiving data representing morphology and corresponding rate measurements of a patient'"'"'s heart;

(b) generating a series of data points, each of the data points having a first data element corresponding to the morphology measurements and a second data element corresponding to the rate measurements; and

(c) discriminating ventricular tachyarrhythmias of the patient by determining a value representing a distribution of the data points.

10. The method of claim 9 wherein step (c) comprises the steps of:

(a) assigning memory addresses to a predetermined range of the data points; and

(b) determining how many of the memory addresses correspond to at least one of the data points.

11. The method of claim 10 wherein step (c) further comprises the step of determining a percentage of the memory addresses that correspond to at least one of the data points.

12. The method of claim 11 wherein step (c) further comprises the step of determining if the percentage is greater than or less than a predetermined threshold value.

13. The method of claim 9 wherein step (c) comprises the step of discriminating monomorphic ventricular tachycardia from polymorphic ventricular tachycardia of the patient by comparing the value to a predetermined threshold value.

14. The method of claim 9 wherein step (a) comprises the steps of:

(a) receiving a morphology signal and a corresponding rate signal of the patient; and

(b) sampling the morphology signal and the rate signal in order to obtain the data.

15. The method of claim 14 wherein the step of sampling further comprises the step of decimating the sampled morphology and rate signals.

16. The method of claim 9 wherein step (a) comprises the step of applying a moving average filter to the data.

17. A method of discriminating ventricular tachyarrhythmias, comprising the steps of:

(a) receiving morphology data and corresponding rate data for a particular patient;

(b) applying a moving average filter to the morphology data and the rate data;

(c) plotting the morphology data and the rate data, using a plurality of data points, on a graph having a first dimension representing morphology and second dimension representing rate;

(d) overlaying a grid, comprising a plurality of cells, on the graph of the morphology and rate data; and

(e) discriminating ventricular tachyarrhythmias of the patient by determining a value related to how many of the cells are occupied by the data points.

18. The method of claim 17 wherein step (c) comprises the step of discriminating monomorphic ventricular tachycardia from polymorphic ventricular tachycardia of the patient by comparing the value to a predetermined threshold value.

19. The method of claim 17 wherein step (c) comprises the step of determining a percentage of the cells that are occupied by the data points.

20. The method of claim 19 wherein step (c) further comprises the step of determining if the percentage is greater than or less than a predetermined threshold value.

21. The method of claim 17 wherein step (a) comprises the steps of:

(a) receiving a morphology signal and a corresponding rate signal of the patient; and

(b) sampling the morphology signal and the rate signal in order to obtain the data.

22. The method of claim 17 wherein step (d) comprises the step of dividing the graph according to a grid of cells having predetermined dimensions.

23. A system for discriminating ventricular tachyarrhythmias, comprising:

receive means for receiving data representing a first channel and a second channel both recording electrocardiographic signals from a patient'"'"'s heart;

means for generating a series of data points, each of the data points having a first data element corresponding to the first channel and a second data element corresponding to the second channel; and

analysis means for discriminating ventricular tachyarrhythmias of the patient by determining a value representing a distribution of the data points.

24. The system of claim 23 wherein the analysis means comprises:

means for assigning memory addresses to a predetermined range of the data points; and

means for determining how many of the memory addresses correspond to at least one of the data points.

25. The system of claim 24 wherein the analysis means further comprises means for determining a percentage of the memory addresses that correspond to at least one of the data points.

26. The system of claim 25 wherein the analysis means further comprises means for determining if the percentage is greater than or less than a predetermined threshold value.

27. The system of claim 23 wherein the analysis means comprises means for discriminating monomorphic ventricular tachycardia from polymorphic ventricular tachycardia of the patient by comparing the value to a predetermined threshold value.

28. The system of claim 23 wherein the receive means comprises:

means for receiving a first electrocardiographic signal from the patient'"'"'s heart and a corresponding second electrocardiographic signal from the patient'"'"'s heart; and

means for sampling the first electrocardiographic signal and the second electrocardiographic signal in order to obtain the data.

29. The system of claim 23 wherein the receive means comprises means for applying a moving average filter to the data.

30. The system of claim 23 wherein the receive means comprises means for receiving data representing morphology and corresponding rate measurements of the patient'"'"'s heart.

31. A system for discriminating ventricular tachyarrhythmias, comprising:

receive means for receiving electrocardiographic signals from a patient'"'"'s heart, comprising;

means for receiving morphology signals; and

means for receiving rate signals;

sampling means for sampling the morphology signals and the rate signals in order to produce a set of morphology data and rate data;

means for generating a series of data points, each of the data points having a first data element corresponding to the morphology data and a second data element corresponding to the rate data; and

analysis means for discriminating ventricular tachyarrhythmias of the patient by determining a value representing a distribution of the data points.

32. The system of claim 31 wherein the analysis means comprises:

means for assigning memory addresses to a predetermined range of the morphology data and the rate data; and

means for determining how many of the memory addresses correspond to at least one of the data points.

33. The system of claim 32 wherein the analysis means comprises means for determining a percentage of the memory addresses that correspond to at least one of the data points.

34. The system of claim 33 wherein the analysis means further comprises means for determining if the percentage is greater than or less than a predetermined threshold value.

35. The system of claim 31 wherein the analysis means comprises means for discriminating monomorphic ventricular tachycardia from polymorphic ventricular tachycardia of the patient by comparing the value to a predetermined threshold value.

36. The system of claim 31 wherein the receive means comprises means for applying a moving average filter to the data.

37. The system of claim 31 wherein the sampling means comprises means for decimating the sampled morphology and rate signals.

38. A system for discriminating ventricular tachyarrhythmias, comprising:

receive means for receiving morphology data and corresponding rate data for a particular patient;

filter means for applying a moving average filter to the morphology data and the rate data;

graphing means for plotting the morphology data and the rate data, using a plurality of data points, on a graph having a first dimension representing morphology and second dimension representing rate;

grid means for overlaying a grid, comprising a plurality of cells, on the graph of the morphology data and the rate data; and

analysis means for discriminating ventricular tachyarrhythmias of the patient by determining a value related to how many of the cells are occupied by the data points.

39. The system of claim 38 wherein the analysis means comprises means for discriminating monomorphic ventricular tachycardia from polymorphic ventricular tachycardia of the patient by comparing the value to a predetermined threshold value.

40. The system of claim 38 wherein the analysis means comprises means for determining a percentage of the cells that are occupied by the data points.

41. The system of claim 40 wherein the analysis means further comprises means for determining if the percentage is greater than or less than a predetermined threshold value.

42. The system of claim 38 wherein the receive means comprises:

means for receiving a morphology signal and a corresponding rate signal of the patient; and

means for sampling the morphology signal and the rate signal in order to obtain the data.

43. The system of claim 42 wherein the sampling means comprises means for decimating the sampled morphology and rate signals.